Earlier this year the British Mountain Medicine Society launched the BMMS Dr Jim Milledge Mountain Medicine Bursary. This award is designed to support those in the early stages of their career who intend to undertake a project in mountain medicine. Further details can be found here. The winners of the 2021 Lucky Jim Award are Ffyon Davies, Christopher Lewis and Diggory North. Here’s Diggory to tell us about what the award means to him.
Thanks Diggory for speaking to me. Can I start by asking you to tell us a little bit about yourself and what winning the award means to you?
I'm a senior house officer working in the Emergency Dept. in Norwich whilst studying an MSc in Sports Medicine in London, floating around post-foundation training. I also work as a sports doctor for Norwich City FC, and am hopefully due to commence a climbing-medicine-specific PhD at Leeds Beckett University from next year if all goes to plan! I've always had a keen interest in climbing injuries and medical problems, from musculoskeletal trauma to mountain-related illnesses.
Winning the Lucky Jim Award was certainly a pleasant surprise! I applied on the advice of the great David Hillebrandt after a conversation with him over the phone. It's been wonderful to network within the tight-knit and welcoming Mountain Medicine community (even if it's mostly been virtual so far!) so it means a lot that the people at the BMMS are willing to support my project.
Tell us about the project that you won the award for. What questions are you trying to answer?
The project will actually form the dissertation for my MSc, and it's looking into healthcare utilisation for climbing injuries in the UK. Bearing in mind Olympic inclusion this summer and the surge in popularity that this will bring, I'm interested in trying to improve the historically poor healthcare relationships between climbers and medical professionals, as we are likely to start seeing more injuries in the sport. For obvious reasons I will focus my attention on soft tissue finger trauma, as these make up the majority of injuries in climbing. There have been a couple of US studies that have analysed the reasons climbers often opt for self- and peer-management of their injuries; of which there are many. To date no one has looked at the awareness and understanding of these injuries amongst the relevant healthcare professionals, as far as I know. I'd like to explore their knowledge and understanding, in the hope that we can identify where the knowledge gaps lie and which specialties would be good targets for disseminating more guidance.
A very useful introduction to climbing injuries can be found in this study of more than 200 US-based rock climbers
How will you go about answering the question?
I'll be undertaking a cross-sectional study based on a questionnaire assessing healthcare professionals' knowledge and awareness of typical climbing injuries, the anatomy, and how to manage them in the healthcare setting. This will be targeted at a range of primary, secondary and tertiary specialities across the UK. I'd like to perform some semi-structured interviews too in order to gain a more qualitative insight into healthcare professionals' confidence with assessing finger injuries and what access to learning resources different specialties have. That's the gist of it anyway!
The best research is often done through collaboration, who will be working with you on this?
The MSc project is being supervised by the great Prof. Roger Wolman at QMUL, a sports medicine and rheumatology consultant. Externally, I'm incredibly lucky to have the support and professional oversight of Dr Gareth Jones at Carnegie School of Sport, Tim Halsey in Rotherham and the legendary Prof. Volker Schöffl over in Bamberg, Germany, albeit virtually in the current climate. (This BMMS prize very much counts as collaboration in my books as well, so thanks!)
Whilst injuries to the hands are particularly common in climbers, there are a number of injuries that affect other parts of the body. Some like those caused by heel hooking are unique to the sport!
How will you present the results?
The precursor to this project is a systematic review that I've just finished, which looks at the outcomes and return-to-sport times for pulley injuries to give us a better idea of the burden of injury on the sport. That should be presented in poster form at the BMRES/BMMS conference this September, all being well. The awarded project is in its infancy now but will be finished by this time next year, and I hope to present again in 2022 and try for publication in a few sports med and wilderness med journals if possible. Beyond presentations and publication, I'm hoping to disseminate the findings among the relevant specialties in the form of taught resources to increase the awareness of climbing injuries, should we demonstrate the need for that.
What are you hoping to learn along the way?
I hope this will give myself and others involved in climbing-related research and clinical work a better idea of how we can improve healthcare relationships with climbers and elite athletes in the sport climbing world. I hope the project will also help me gain a footing in the worlds of sports and mountain medicine going forward, where I hope to meet more like-minded people to collaborate and geek out with!
Thanks Diggory! Good Luck!
Diggory recently completed one of our "On Belay With..." interviews. Read his answers here.
For more on growth plate injuries in young climbers take a look at this.